Shared Governance in Action –Quality Panel DialogueRandy Axelrod, MD—Executive Vice President,Clinical and Patient Services

Shared governance in action

Providence Health & Services | 2014 SHARED GOVERNANCE ANNUAL REFRESHER

Panelists:Chuck Watts, MD, System Board Quality Committee Chair-elect Doug Watson, CMB Chair, Providence Senior & Community Services (PSCS)Robert Hellrigel, SVP & Chief Executive, PSCSRick Waller, MD, Vice Chair, Oregon Region CMB Doug Koekkoek, MD, Regional CMO, Oregon Region

Moderator:Randy Axelrod, MD, EVP Clinical/Patient Services

Highlighting Select Shared Governance Themes

• Engaging our clinicians• Clinical privileges and credentials• Quality and safety across the care continuum• PH&S Board Quality & Patient Safety Committee

Providence Health & Services | 2014 SHARED GOVERNANCE ANNUAL REFRESHER

Utilizing “Expert to Expert” collaboration across clinical areas and care operations is how and where we start clinical transformation

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Clinical prioritiesCancerCardiovascularMusculoskeletalNeurosciencesWomen's and Children's

Care operation prioritiesCritical CareImagingLabPharmacySurgery

Clinical Focus Groups are driven by the clinicians, staffed with Portfolio Director and project managers and facilitated by robust information. Each focus group has a physician and executive lead the work

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Challenge questions are designed to emphasize the key opportunities• Resource Costs

– What areas can we identify cost savings through preferred selection and contracting? • Care Pathways and Quality

– What guidelines can be rapidly adopted to limit variation and improve clinical outcomes and patient experience?

• Innovation, Technology and Research– How should we assess new technology and research opportunities?

• Advanced Care Models– What opportunities exist to “package” our care and change our reimbursement models to our

market and communities• Population Health and Prevention

– What programs should we promote to improve the overall state of CV care and population health?• Epic and Data

– What are the data and support needs to improve outcomes?Providence Health & Services | 2014 SHARED GOVERNANCE ANNUAL REFRESHER

Clinical privileges

• Case example: Privileging for robotic surgery• Shared governance topics:– Adjudication of local resistance to system-developed

standards– Consideration of stewardship implications beyond local

geographic boundaries

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Quality & Safety across the continuum

• Case example: Supporting regional efforts to reduce hospital readmissions

• Shared governance topics:– Who owns “quality” in the continuum?– Maintaining open, effective communication and priority

setting

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PH&S Board Quality & Safety Committee

• Monitor how we move quality, safety, and innovation across critical areas of patient care and clinician engagement – moving from concept to “hard-wiring”

• Facilitate expert to expert coordination across all of our CMBs

• Assist our leadership with coordination of key relationships and enabling capabilities to optimize and highlight all CMBs effortsProvidence Health & Services | 2014 SHARED GOVERNANCE ANNUAL REFRESHER

Table Discussion• How are these and other shared governance challenges being

discussed within your regions?• What are the barriers CMB members and management will need to

address to ensure success? How can we facilitate these issues?– “1-2-4-All” approach– By yourself – 2 minutes– In a pair – 3 minutes– As a table – 5 minutes

• Report out top 1-2Providence Health & Services | 2014 SHARED GOVERNANCE ANNUAL REFRESHER